Psychometric Properties of the Turkish Adaptive Coping with Disease Scale in Adult Cancer Patients

OBJECTIVES

We evaluated the psychometric properties of the Turkish version of the Adaptive Coping with Disease Scale (ACDS) questionnaire for Turkish patients with cancer.

METHODS

A total of 175 patients with cancer aged 18 to 65 years were referred to a university hospital in Ankara, Türkiye. The patients, selected by convenience sampling in 2024, completed the Descriptive Form and Turkish versions of the ACDS questionnaire. The construct validity of the scale was assessed through confirmatory factor analysis and exploratory factor analysis. Pearson's correlation analysis was conducted to evaluate the relationships between item-total scores and item-subscale total scores. The reliability of the scale was determined using Cronbach's alpha coefficient. In addition, the scale language validity and test-retest reliability were evaluated. The data were analyzed using the IBM SPSS Statistics and AMOS 25.

RESULTS

The scale demonstrated high validity (content validity index = 0.97, interclass coefficient = 0.721, P < .001), indicating high stability and consistency of test scores over time. The comparative fit index confirmed the six-factor structure of the ACDS scale, excluding item 13. The Kaiser-Meyer-Olkin coefficient was 0.738, and Bartlett's test yielded a value of 2305.623 (P < .001). Fit indices indicated a good model fit (χ²/degrees of freedom = 1.98, root mean square error of approximation = 0.074, comparative fit index = 0.815). The scale exhibited acceptable internal consistency, with an overall Cronbach's alpha of 0.78. The total explained variance ratio was 57.14%.

CONCLUSIONS

The Turkish version of ACDS in patients with cancer is a reliable and valid questionnaire that can be used in clinics and research.

IMPLICATIONS FOR NURSING PRACTICE

Nurses can use the ACDS to assess the level of disease-related stress experienced by patients with cancer. In addition, they can guide the patients to develop effective coping methods and a better quality of life.

The Effect of Religious-Spiritual Psychotherapy on Illness Perception and Inner Strength among Patients with Breast Cancer in Iran

Women diagnosed with breast cancer often suffer from illness-related issues, which negatively impact their illness perception and inner strength following diagnosis and/or during treatment. An investigation of the effectiveness of religious-spiritual psychotherapy based on the Twelver Shia Sects of Islam (RSP-TSS) was conducted among hospitalized cancer patients to determine whether it improved their disease perception and inner strength. Forty-five women (ages 31-58) diagnosed with breast cancer in Iran were randomly assigned to RSP-TSS (n = 15), attention control (n = 15) and untreated control groups (n = 15). To meet the needs of hospitalized participants, the manualized RSP-TSS protocol was adapted to consist of ten sessions, each lasting 90 min. Sessions were conducted once weekly for 10 weeks. Primary outcome measures were the Revised Illness Perception Questionnaire (IPQ-R) and the Inner Strength Questionnaire (ISQ). Data were collected in pre-intervention, post-intervention, and 4 months following the intervention. Repeated MANOVA measures showed that, as compared with the attention control and untreated control groups, the RSP-TSS group achieved significant improvements in illness perception and inner strengths, and those gains were maintained during the 4-month follow-up. By reframing illness perception and building inner strength, spiritual and religious-based interventions may improve patients coping with cancer and improve the quality of life for women hospitalized with breast cancer. These promising results warrant further investigation into the efficacy of spiritual and religious-based interventions to remediate illness perception and inner strength problems in women diagnosed with serious medical illnesses.

Examining the impact of cancer on survivors' religious faith: A report from the American Cancer Society study of cancer survivors-I

OBJECTIVES

The impact of religion/spirituality (R/S) on cancer outcomes, including health-related quality of life (HRQoL), has been the topic of much investigation. Reports of the opposite, that is, the impact of cancer on R/S and associations with HRQoL, are few. The current study sought to explore the positive and negative impacts of cancer on the religious faith of survivors as well as the associations of such impacts with HRQoL.

METHODS

Participants included 2309 9-year survivors of cancer from the American Cancer Society's Studies of Cancer Survivors-I. The impact of cancer on R/S was measured using items from the Patient-Reported Outcomes Measurement Information System (PROMIS) psychosocial impact of illness-faith, and HRQoL was measured with the 12-item short form (SF-12). Hierarchical regressions were used to examine the impact of cancer on R/S controlling for medical and demographic covariates.

RESULTS

Consistent with hypotheses, the majority of survivors (70%) reported that cancer had a positive impact on religious faith, while the negative impact of cancer on religious faith was relatively rare (17%). In multivariable models, the negative impact of cancer on faith was associated with poorer HRQoL, both mental and physical, while the positive impact of cancer on faith was associated with greater mental well-being.

CONCLUSIONS

Cancer has a negative impact on religious faith for a minority of survivors. However, when it is reported, such negative impact is indicative of poorer mental and physical well-being. As such, it is important to identify those survivors at risk early in survivorship and provide support and intervention as needed.

Relationship Between Spiritual Well-Being and Hope in Patients with Cardiovascular Disease

Spirituality and hope have been identified as important constructs in health research, since both are thought to enhance a person's ability to cope with the consequences of serious illness. The aim of this study was to examine the relationship between spiritual well-being and hope in patients with cardiovascular disease. Using descriptive, correlational methodology, the investigator gathered data on a convenience sample of 500 patients with cardiovascular disease who were hospitalized in a medical institution in Iran. The study was conducted over a four-month period. Participants completed a demographic questionnaire, the Spiritual Well-Being Scale (SWBS) and the Herth Hope Index (HHI). The mean score on the SWBS and HHI was 86.21 (SD 12.46) and 34.80 (SD 5.05), respectively. Multivariate predictors for spiritual well-being were female gender (p = 0.047), religiosity (p = 0.018), and hope (p < 0.001). Significant predictors of hope were marital status (p < 0.001), educational status (p < 0.001), economic status (p < 0.001), and spiritual well-being (p < 0.001). Findings suggest that multiple factors may impact spiritual well-being and hope. Therefore, this study has implications for those providing care to patients with cardiovascular disease.

Age Differences in the Coping Strategies of Patients With Colorectal Cancer

BACKGROUND

Colon and/or rectum cancer (CRC) patients use various strategies to cope with their condition, and these can vary between age groups.

OBJECTIVES

The aims of this study were to investigate differences between psychosocial/spiritual variables and coping strategies in CRC patients of different age groups (younger vs older) and to identify the predictors of coping for both age groups.

METHODS

A cross-sectional descriptive study was conducted at 3 outpatient clinics in Korea. The Hospital Anxiety and Depression Scale, Social Support Scale, and Self-Transcendence Scale were used to measure psychosocial and spiritual variables; the Mini-Mental Adjustment to Cancer Scale was used to assess cancer-specific coping strategies.

RESULTS

Both younger and older patients who were psychologically distressed used more maladaptive coping. Individuals who received less social support from healthcare providers used more maladaptive coping strategies. For younger patients, self-transcendence was the only significant predictor of both adaptive and maladaptive coping strategies; for older patients, Hospital Anxiety and Depression Scale score was the only significant predictor of maladaptive coping.

CONCLUSION

Differences in psychological distress, social support, and self-transcendence due to age are important protective or risk factors for the use of coping strategies among CRC patients.

IMPLICATIONS FOR PRACTICE

Considering our findings, we encourage healthcare professionals to be aware of patients' coping strategies and take them into account when planning age-specific interventions related to coping, before hospital discharge.

"I always tried to forget about the condition and pretend I was healed": coping with cervical cancer in rural Ghana

Background

Cervical cancer is a very common disease among women in Ghana and in the world as a whole. However, there is a dearth of information on the mechanisms cervical cancer patients adopt to cope with the condition in Ghana. This study sought to explore the strategies adopted by cervical cancer patients in rural Ghana to cope with the disease.

Methods

In-depth interviews were conducted to collect qualitative data from cervical cancer patients in a health facility in the Volta Region of Ghana. Data processing was done using the R software package for Qualitative Data Analysis (RQDA) and a thematic approach was used to analyse and present the results.

Results

The results show that cervical cancer patients adopted personal and psychological strategies such as sexual abstinence, personal hygiene, and disease denial to cope with the condition. Respondents also described social, financial and non-material support services they received from family members and the church as critical resources, which helped them to manage the conditions of the disease. Respondents also reported that faith healing, herbal and orthodox medicines helped them to manage the symptoms of the disease.

Conclusions

Cervical cancer patients used a variety of coping strategies to manage the disease. Yet, it will be essential for interventions to focus on strengthening knowledge about the disease. This study underscores the need for financial, social and material support as well as an encouragement of the use of health services among cervical cancer patients.

Spirituality and social responsibility performance

Purpose

This paper aims to discuss how religiously and non-religiously affiliated individuals may view the three core workplace spiritual values: transcendence, existence of a higher power and interconnectedness. Additionally, this paper studies how the contrasts between the views of religiously and non-religiously affiliated individuals about the three core spiritual values affect their performance of social responsibility initiatives.

Design/methodology/approach

A conceptual analysis was used.

Findings

This paper suggests that religiously and non-religiously affiliated individuals view the three core spiritual values differently. Drawing upon the three core spiritual values viewed by religiously and non-religiously affiliated individuals, this paper proposes the following. First, religiously affiliated individuals will focus on implementing social responsibility initiatives for a longer time orientation compared to non-religiously affiliated individuals. Second, when engaging in social responsibility, religiously affiliated individuals will focus on implementing a smaller scope of social responsibility initiatives than non-religiously affiliated individuals. Finally, religiously affiliated individuals will focus on implementing a larger scale of social responsibility initiatives than non-religiously affiliated individuals.

Originality/value

This paper is one of the very first studies addressing how religiously and non-religiously affiliated individuals view core values of spirituality. Additionally, this paper advances the literature by contrasting how religiously and non-religiously affiliated individuals engage in socially responsible initiatives in accordance with how they view spirituality.

The Burden of Low Back Pain Among Fishermen: A Survey in a Rural Fishing Settlement in Rivers State, Nigeria

Although fishing is of great economic importance, it has been described as a very dangerous and strenuous occupation worldwide. The current study was designed to determine the prevalence of low back pain (LBP) and explore the coping strategies of fishermen in the Oyorokoto fishing settlement in Nigeria. Three hundred and eighty-four fishermen with an age range of 18 to 64 years and a mean age of 34.12 years (SD = 6.52) were recruited. LBP was identified in 262 (68.23%) of the participants. LBP was significantly associated with age, educational status, and body mass index (BMI; χ² = 102.23, p < .001) but not with marital status (p = .211). Severe LBP was identified among participants who were in the age group 35 to 44 years (33.93%), married (79.46%), primary education (45.54%), and abnormal BMI (73.32%). Participants ≥55 years (6.25%), widowers (1.79%), tertiary education (3.57%), and normal BMI (27.68%) had the least LBP. LBP was least prevalent in those who had practiced fishing for a duration of ≥21 years (25.57%) as compared with other groups (χ² = 10.49, p = .03). The number of fishing trips per week was not significantly associated with the severity of LBP. Significant difference was identified between those who used nonmotorized boats as compared with motorized types (χ² = 12.75, p = .002). The coping strategy with the highest score was religion 7.23 (SD = 1.12). The coping strategy with the lowest score was substance abuse 3.01 (SD = 0.57). In conclusion, LBP is an important health problem among fishermen. Religion is the most common coping strategy used by the fishermen.

Older people living alone at home with terminal cancer

This study describes the lived experiences of older people coping with terminal cancer and living alone, focusing on how they face challenges of the biographical life changes from their disease progression. Face-to-face semi-structured interviews were conducted in two phases with palliative care clients of a community-based service in Western Australia (2009-2011): Brief interviews with 43 cancer patients who live alone and then in-depth interviews with 8 of them. Using biographical disruption as the analytical framework for interpreting the qualitative data, four main themes emerged: Biographical disruption: adjusting to change; Biographical continuity: preserving normality; Biographical reconstruction: redefining normality; and Biographical closure: facing the end. Biographical disruption was a suitable framework for analysis, permitting identification of the biographical disruptions of the individual's world and the reframing that is undertaken by the individual to maintain autonomy and independence while acknowledging and accepting their closeness to death. Understanding the factors associated with the individual's need to maintain their own identity will enable nurses working with this population to tailor support plans that meet the individuals' needs while maintaining or restoring the person's sense of self. Interventions that directly address end-of-life suffering and bolster sense of dignity and personhood need to be considered.

Spiritual wellbeing of Iranian patients with acute coronary syndromes: a cross-sectional descriptive study

Spiritual wellbeing harmonises several dimensions of human life and is essential for coping with diseases. Acute coronary syndromes (ACS) cause crisis in physical, psychological aspects and spiritual dimensions of patients’ lives. The purpose of this study was to determine the level of spiritual wellbeing and its dimensions in patients with ACS. For this, a cross-sectional descriptive study was conducted. For data collection, Paloutzian and Ellison’s Spiritual Wellbeing Self-report Questionnaire was filled in by 364 patients with ACS. Patients referred to the cardiac wards of five teaching hospitals in Tehran between August 2011 and April 2012 were recruited using the convenience sampling method. The data were analysed using descriptive and inferential statistics. The findings revealed that the majority of patients (97.9%) benefited from moderate spiritual wellbeing, although religious wellbeing was higher than existential wellbeing in the patients. It is concluded that nurses are required to improve their cultural and contextual knowledge of patients’ spiritual wellbeing to meet patients’ needs in nursing care. Spiritual beliefs can influence coping with diseases, help patients to find meaning and purpose in life to deal with problems resulting from physical and mental illnesses. These findings can be used to suggest the incorporation of religious aspects of spirituality into care programmes designed to improve the quality of life of patients with ACS.

Faith as a resource in patients with multiple sclerosis is associated with a positive interpretation of illness and experience of gratitude/awe

The aim of this cross-sectional anonymous survey with standardized questionnaires was to investigate which resources to cope were used by patients with multiple sclerosis (MS). We focussed on patients' conviction that their faith might be a strong hold in difficult times and on their engagement in different forms of spirituality. Consecutively 213 German patients (75% women; mean age 43 ± 11 years) were enrolled. Fifty-five percent regarded themselves as neither religious nor spiritual (R-S-), while 31% describe themselves as religious. For 29%, faith was a strong hold in difficult times. This resource was neither related to patients' EDSS scores, and life affections, fatigue, negative mood states, life satisfaction nor to Positive attitudes. Instead it was moderately associated with a Reappraisal strategy (i.e., and positive interpretation of illness) and experience of gratitude/awe. Compared to spiritual/religious patients, R-S- individuals had significantly (P < .0001) lower Reappraisal scores and lower engagement in specific forms of spiritual practices. The ability to reflect on what is essential in life, to appreciate and value life, and also the conviction that illness may have meaning and could be regarded as a chance for development was low in R-S- individuals which either may have no specific interest or are less willing to reflect these issues.

Spirituality in Men With Advanced Prostate Cancer

Spirituality is often regarded as being helpful during an unwell person’s journey but definitions of the concept can be confusing, and its use synonymously with religion can be misleading. This research sought to answer the question, “What is the nature of spirituality in men with advanced prostate cancer,” and to discover the role spirituality may have in these men as they face the challenges of living with their disease. A qualitative approach and narrative method was used to explore the spirituality of nine men with advanced prostate cancer who volunteered to participate and to tell the story of their cancer journey with particular focus on their spirituality. The study found that spirituality for these men, who were all Caucasians, was a “holistic thing” that involved physical, psychosocial, and spiritual matters that enabled them to transcend the everyday difficulties of their journey. Through their spirituality they obtained greater comfort and peace of mind during what was for many of them a very traumatic time. The central theme in the men’s stories was that of connectedness—to themselves, to their partners, sometimes to a higher being, to other people such as their family and friends, and to other aspects of their lives.

Are spirituality and religiosity resources for patients with chronic pain conditions?

OBJECTIVE

We studied whether or not spirituality/religiosity is a relevant resource for patients with chronic pain conditions, and to analyze interrelations between spirituality/religiosity (SpREUK Questionnaire; SpREUK is an acronym of the German translation of "Spiritual and Religious Attitudes in Dealing with Illness"), adaptive coping styles that refer to the concept of locus of disease control (AKU Questionnaire; AKU is an acronym of the German translation of "Adaptive Coping with Disease"), life satisfaction, and appraisal dimensions.

PATIENTS

In a multicenter cross-sectional study, 580 patients with chronic pain conditions were enrolled.

RESULTS

We found that the patients relied on both external powerful sources of disease control and on internal powers and virtues, while Trust in Higher Source (intrinsic religiosity) or Illness as Chance (reappraisal) were valued moderately; Search for Meaningful Support/Access (spiritual quest orientation) was of minor relevance. Stepwise regression analyses revealed that the internal sources of disease control, such as Conscious and Healthy Way of Living and Positive Attitudes, were (apart from the religious denomination) the strongest predictors of patients' reliance on spirituality/religiosity. Both behavioral styles were rated significantly lower in patients who regarded themselves as neither religious nor spiritual. Positive disease interpretations such as Challenge and Value were clearly associated with a spiritual quest orientation and intrinsic religiosity.

CONCLUSION

The associations between spirituality/religiosity, positive appraisals. and internal adaptive coping strategies indicate that the utilization of spirituality/religiosity goes far beyond fatalistic acceptance, but can be regarded as an active coping process. The findings support the need for further research concerning the contributions of spiritual coping in adjustment to chronic pain.

Adaptive coping strategies in patients with chronic pain conditions and their interpretation of disease

Background

We examined which adaptive coping strategies, referring to the concept of 'locus of disease control', were of relevance for patients with chronic pain conditions, and how they were interconnected with patients' life satisfaction and interpretation of disease.

Methods

In a multicenter cross-sectional anonymous survey with the AKU questionnaire, we enrolled 579 patients (mean age 54 ± 14 years) with various chronic pain conditions.

Results

Disease as an adverse interruption of life was the prevalent interpretation of chronic pain conditions. As a consequence, patients relied on external powerful sources to control their disease (i.e., Trust in Medical Help; Search for Information and Alternative Help), but also on internal powers and virtues (i.e., Conscious Way of Living; Positive Attitudes). In contrast, Trust in Divine Help as an external transcendent source and Reappraisal: Illness as Chance as an internal (cognitive) strategy were valued moderately. Regression analyses indicated that Positive Attitudes and higher age were significant predictors of patients' life satisfaction, but none of the other adaptive coping strategies. While the adaptive coping strategies were not associated with negative interpretations of disease, the cognitive reappraisal attitude was of significant relevance for positive interpretations such as value and challenge.

Conclusions

The experience of illness may enhance intensity and depth of life, and thus one may explain the association between internal adaptive coping strategies (particularly Reappraisal) and positive interpretations of disease. To restore a sense of self-control over pain (and thus congruence with the situation), and the conviction that one is not necessarily disabled by disease, is a major task in patient care. In the context of health services research, apart from effective pain management, a comprehensive approach is needed which enhances the psycho-spiritual well-being of patients.

The BENEFIT through spirituality/religiosity scale--a 6-item measure for use in health outcome studies

OBJECTIVE

We intended to develop a brief and compact scale which measures the beneficial effects of spirituality/religiosity (SpR) on several dimensions of patients' life concerns, to be used in health outcome studies.

METHOD

To attain a short measure valid for spiritual and religious dimensions, we designed a scale based on tested items of an independent item pool of the already established SpREUK inventory, which measures SpR attitudes and convictions and holds an independent data pool addressing the support of life concerns through SpR. To validate the intended BENEFIT scale, reliability and factor analyses were performed utilizing 371 individuals with different chronic diseases recruited in various medical centers in Germany (exploratory analysis), while for the confirmatory analyses we used an independent pool of 229 patients with chronic pain conditions.

RESULTS

Six items addressed the beneficial effects of SpR of the patients' concerns, and thus were chosen for the BENEFIT scale. These items had a good internal reliability (Cronbach's alpha = 0.922). Primary factor analysis pointed to a 1-factor solution, which explained 72% of variance. Correlation analyses revealed that the BENEFIT scale correlated with both uniquely religious and spiritual attitudes.

CONCLUSIONS

The data demonstrate the reliability and validity of the 6-item BENEFIT scale that captures a unique aspect of SpR that can be used in epidemiological studies and clinical trials for those who wish to assess both the external and internal dimensions of SpR. This brief instrument can be easily incorporated into almost any study of mental health, physical health, or quality of life.

Reliance on God's help, depression and fatigue in female cancer patients

OBJECTIVE

Because an increasing number of studies indicate that a religious attitude is associated with lower depression, we intended to investigate the interrelationship between intrinsic religiosity and depressive behavioral symptoms in cancer patients with long-term courses.

METHOD

In 396 female cancer patients recruited in East-Germany, intrinsic religiosity was measured with the scale Reliance on God's Help (RGH) from the AKU questionnaire; anxiety and depression with the Hospital Anxiety and Depression Scale; fatigue with the cancer fatigue scale (CFS-D); physical and mental health with the SF-12; adaptive coping styles and ESCAPE from illness with the AKU; and life satisfaction with a modification of Huebner's Brief Multidimensional Students' Life Satisfaction Scale.

RESULTS

Moderate depression-associated fatigue was prevalent in cancer patients with long term-cancer courses, while depression and anxiety were of minor prevalence. RGH, which was valued by several patients, correlated with Reappraisal: Illness as Chance; with life satisfaction dimensions such as future perspectives, overall life, and financial situation; to a small extend with Escape from Illness; and negatively with mental health. No significant correlations were found with respect to depression, anxiety, or fatigue.

CONCLUSIONS

In contrast to cancer patients in final stages, cancer patients with long-term courses had just a moderate reliance on external divine powers. The addressed depressive behavioral symptoms were connected with internal adaptive coping styles such as Conscious Living/Positive Attitudes rather than intrinsic religiosity in response to disease.